Keeping Ebola out of Liberia - WHO

Over a month has passed since Ebola transmission ceased in Liberia.
This hard-fought achievement is still being celebrated across the
country, where nearly 11,000 people became infected with the virus and
4,800 died.

All 6 districts of north-western Lofa County share a border
with Guinea or Sierra Leone, where the Ebola transmission continues.

Every day, hundreds of people pour into Lofa from the 2 Ebola-hit
countries — traders, merchants, farmers and other economic migrants,
relatives of Liberians attending weddings and funerals and patients
going to Liberian health centres in border towns. On market days, the
numbers double.

They enter Liberia through 33 official border
checkpoints and nearly 300 unofficial, mostly unmanned crossings."We are at high risk that Ebola will resurface in Liberia as
long as transmission continues in neighbouring countries," warns Tamba
Alpha, the top surveillance officer in Lofa and the man in charge of
implementing the Liberian Government’s action plan to prevent
re-importation of the virus.

"My greatest worry is that people think
Ebola is finished and are going back to their normal practices at a time
when community members, health workers, local authorities, security,
everyone needs to continue precautions and surveillance."

Active surveillance is part of a larger strategy

Active surveillance and infection prevention and control
measures at Liberia’s borders and in border communities and health
facilities is one part of a larger Liberian Government surveillance
strategy, designed in partnership with WHO, to prevent a reintroduction
of Ebola.

The Liberian Government is training hundreds of health
workers, security personnel, and national, county and district
officials, with the help of WHO and other key partners.

They are being
trained in surveillance protocols and procedures, monitoring compliance,
beefing up security and health staff at checkpoints, boosting
cross-border cooperation with Guinea and Sierra Leone and revising
public messages — urging vigilance until Ebola is gone from the region. The plan is both ambitious and extremely challenging. Lofa is one of 5 Liberian counties that border Guinea or
Sierra Leone. Mr Alpha says 160 trained health workers have been
deployed with immigration and security staff at official border
crossings to screen for symptoms of Ebola and other infectious diseases.

Nine isolation rooms are in place at primary checkpoints with more on
the way. Critical information is exchanged at monthly coordination
meetings with counterparts in Guinea, Sierra Leone, WHO and other
partners. But he still has many concerns. He ticks off a list of
staffing, technical capacity and financial constraints.

Mostly, he’s
concerned about loosening infection prevention and control practices in
border communities and at clinics, as well as the large number of people
who enter unchecked Lofa County at informal border crossings. WHO field coordinator Anthony Kergosien, who has been working
closely with Mr Alpha and the County Health Team, says community
surveillance was key to containing Ebola during the emergency and will
be one of the most important factors in keeping the virus from
returning."During the outbreak in Liberia, community health workers and
volunteers played a critical role in detecting something wrong in their
villages and raising alarm," says Mr Kergosien.

"We need community
members to stay engaged, active and alert and to keep spreading messages
of caution and vigilance. They are Liberia’s best sentinels."